Table 5.

Radiotherapy (RT) and psychological adjustment

Study	Design	Characteristics of the sample	Major findings
Caffo et al. (1996)	• Retrospective "ad hoc" QOL questionnaire inquiry following RT	• 70 patients with localized PCA	• Psychological adjustment and relational well-being good • Level of available information about PCA and RT correlate with adjustment
Joly et al. (1998)	• Retrospective, controlled study of health-related QOL (EORTC)	• 71 patients with localized disease treated with combined external beam RT and brachytherapy	• Treatment has no adverse effects • Patients and controls similar on a range of measures but sexual and urinary symptoms more common in patients
Artebery et al. (1997)	• Retrospective questionnaire (EORTC Prostate) study following brachytherapy	• 51 patients with localized PCA	• Only a minority report psychological distress or disrupted social/family life • Return rate to work – 93% • 100% would recommend treatment to others
Monga et al. (1997)	• Prospective • Aim was to determine cause of fatigue in PCA patients receiving RT through questionnaire (Beck Depression Inventory and 2 sleep scales) and measure of neuromuscular efficiency (NME)	• 13 patients with localized PCA	• Significant but transient decline in NME, independent of psychological status; thus fatigue physically – based rather than influenced by depression
Monga et al. (1999)	• Prospective evaluation, including fatigue, at 4 points – before, during and after RT • Same measures as in Monga et al. (1997)	• 36 patients with localised PCA	• Fatigue scores significantly higher at end of treatment • Not associated with psychological status eg. depression or with sleep. • May be secondary to decline in neuromuscular efficiency and increased muscle fatigue
Greenberg et al. (1993)	• Prospective study of fatigue and mood (Beck Depression Inventory) during treatment	• 15 patients with localised PCA	• Fatigue increases with treatment, but independent of depression • Fatigue associated with increased interleukin – 1 which could be a marker for fatigue associated with RT